Cardiovascular disease (CVD) is the leading cause of death among American Indians/Alaska Natives (AllAN). AllAN populations have experienced a dramatic rise in obesity, diabetes, and ultimately CVD, accompanied by higher fat intake and decreased physical activity. Risk factors for CVD are well known and reducible through weight loss and modified dietary patterns. Little information is available on the prevalence of CVD in AllAN populations, particularly the majority who left the reservations and now resides in urban centers. The specific aims of the project are to: 1) collect baseline data on CVD risk factors from a sample of 60 urban Indian adolescents 2) present a culturally appropriate dietary and physical activity intervention 3) determine if the intervention reduces CVD risk factors and 4) test the practicality of various program methods in preparation for permanent and more thorough chronic disease risk assessment and intervention programs dealing with urban Indian populations. A total of 60 AllAN youth ages 12-18, both male and female, will be recruited from an existing youth program. Interested youth will be enrolled in the intervention and those that decline participation will serve as controls. The intervention will last for 12 months, with six months of supervised activity and six months of self-directed activity. Supervised activity will consist of twice weekly physical activity sessions followed by a meal. Nutrition and health education sessions will be integrated into the curriculum. The primary hypothesis to be tested is whether a culturally appropriate physical activity and nutrition intervention results in improvement of CVD risk factors. The secondary hypothesis is that youth participating in the intervention will make significant improvements from baseline in cardiovascular fitness and diet at the end of the intervention. The intervention will take place at the Seattle Indian Health Board, a multi-service community health center which provides health care to King County AI/ANs and has operated a youth program for over 20 years. Potential benefits to participants include improved cardiopulmonary fitness, better understanding of prudent diet choices and ultimately reduced dsk of cardiovascular as well as other chronic disease. Program benefits include compilation of basic anthropometric data and other information on the extent of CVD risk in urban AI/AN adolescents. If successful, the intervention could then be replicated in other urban Indian programs to expand the benefits to other Al/AN populations.